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Abductor Muscle Function and Trochanteric Tenderness After Hemiarthroplasty for Femoral Neck Fracture.

https://arctichealth.org/en/permalink/ahliterature281385
Source
J Orthop Trauma. 2016 Jun;30(6):e194-200
Publication Type
Article
Date
Jun-2016
Author
Arkan S Sayed-Noor
Aleksandra Hanas
Olof G Sköldenberg
Sebastian S Mukka
Source
J Orthop Trauma. 2016 Jun;30(6):e194-200
Date
Jun-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cohort Studies
Female
Femoral Neck Fractures - diagnosis - surgery
Follow-Up Studies
Hemiarthroplasty - adverse effects - methods
Hospitals, Teaching
Humans
Injury Severity Score
Linear Models
Logistic Models
Male
Middle Aged
Pain Measurement
Pain, Postoperative - diagnosis - therapy
Prospective Studies
Psoas Muscles - physiopathology
Risk assessment
Statistics, nonparametric
Sweden
Treatment Outcome
Abstract
To compare the abductor muscle function and trochanteric tenderness in patients operated with hemiarthroplasty using the direct lateral (DL) or posterolateral (PL) approach for displaced femoral neck fracture.
Prospective cohort study.
A secondary teaching hospital.
We enrolled 183 hips operated with hemiarthroplasty for displaced femoral neck fracture using the DL or PL approach.
Preoperatively, we evaluated the Harris hip score (HHS) and European Quality of Life-5 Dimensions (EQ-5D). At 1 year postoperatively, lucid patients were clinically examined to evaluate the Trendelenburg sign, abductor muscle strength with a dynamometer, and trochanteric tenderness with an electronic algometer. The 1-year HHS and EQ-5D were documented.
The primary outcome was the incidence of postoperative Trendelenburg sign, whereas the secondary outcomes included patients' reported limp, abductor muscle strength, trochanteric tenderness, HHS, and EQ-5D.
There were 48 patients (24 in the DL group and 24 in the PL group) who attended the 1-year clinical follow-up. The 2 groups were comparable (P > 0.05). The DL group showed a higher incidence of the Trendelenburg sign (9/24 vs. 1/24, P = 0.02) and limp (12/24 vs. 2/24, P = 0.004). Further analysis with logistic regression showed the surgical approach to be the only factor that resulted in the increment. No differences regarding HHS, EQ-5D, abductor muscle strength, algometer pressure pain threshold, and radiologic measurements were found (P > 0.05).
The incidence of the Trendelenburg sign and limp were significantly higher in the DL approach although this seemed not to influence abductor muscle strength or the incidence of trochanteric tenderness or compromise the clinical outcome.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
PubMed ID
27206260 View in PubMed
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Acceptability of a wearable hand hygiene device with monitoring capabilities.

https://arctichealth.org/en/permalink/ahliterature155144
Source
J Hosp Infect. 2008 Nov;70(3):216-22
Publication Type
Article
Date
Nov-2008
Author
V M Boscart
K S McGilton
A. Levchenko
G. Hufton
P. Holliday
G R Fernie
Author Affiliation
Toronto Rehabilitation Institute, Toronto, Ontario, Canada. boscart.veronique@torontorehab.on.ca
Source
J Hosp Infect. 2008 Nov;70(3):216-22
Date
Nov-2008
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Cross Infection - prevention & control
Electronics
Female
Focus Groups
Gels - administration & dosage
Hand Disinfection
Hospitals, Teaching
Humans
Infection Control - instrumentation - methods
Male
Middle Aged
Ontario
Reminder Systems - instrumentation
Abstract
Transmisssion of infection within healthcare institutions is a significant threat to patients and staff. One of the most effective means of prevention is good hand hygiene. A research team at Toronto Rehabilitation Institute, Ontario, Canada, developed a wearable hand disinfection system with monitoring capabilities to enhance hand wash frequency. We present the findingsof the first phase of a larger study addressing the hypothesis that an electronic hand hygiene system with monitoring and reminding propertieswill increase hand hygiene compliance. This first phase focused on the acceptability and usability of the wearable electronic hand wash device ina clinical environment. The feedback from healthcare staff to the first prototype has provided evidence for the research team to continue with the development of this technology.
Notes
Erratum In: J Hosp Infect. 2009 Apr;71(4):389
PubMed ID
18799234 View in PubMed
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Addressing postdischarge adverse events: a neglected area.

https://arctichealth.org/en/permalink/ahliterature158206
Source
Jt Comm J Qual Patient Saf. 2008 Feb;34(2):85-97
Publication Type
Article
Date
Feb-2008
Author
Dennis Tsilimingras
David Westfall Bates
Author Affiliation
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, USA. dtsilimingras@yahoo.com
Source
Jt Comm J Qual Patient Saf. 2008 Feb;34(2):85-97
Date
Feb-2008
Language
English
Publication Type
Article
Keywords
Aftercare
Canada
Hospitals, Teaching
Humans
Internal Medicine
Patient Discharge
Quality Assurance, Health Care
Safety Management
Treatment Outcome
United States
Abstract
Postdischarge safety is an area that has long been neglected. Recent studies from the United States and Canada found that about one in five patients discharged home from the general internal medicine services of major teaching hospitals suffered an adverse event.
MEDLINE, Cochrane databases, and reference lists of retrieved articles were used in a literature search of articles published from 1966 through May 2007.
Patient safety research has focused mostly on adverse events in hospitalized patients. Although some data are available about the ambulatory setting, even fewer studies have been done focusing on adverse events following hospital discharge. Only two studies conducted in North America have examined the incidence rate of all types of postdischarge adverse events. On the basis of the available evidence, key areas of opportunity to improve postdischarge care are as follows: (1) improving transitional care, (2) improving information transfer through strategic use of electronic health records, (3) medication reconciliation, (4) improving follow-up of test results, and (5) using screening methods to identify patients with adverse events.
Limited evidence suggests that about one in five internal medicine patients suffers an adverse event after discharge from a North American hospital. The risk of postdischarge adverse events should be recognized by patient safety experts as an important area of concern.
PubMed ID
18351193 View in PubMed
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Advance directives: the views of health care professionals.

https://arctichealth.org/en/permalink/ahliterature221256
Source
CMAJ. 1993 Apr 15;148(8):1331-8
Publication Type
Article
Date
Apr-15-1993
Author
M. Kelner
I L Bourgeault
P C Hébert
E V Dunn
Author Affiliation
Department of Behavioural Science, University of Toronto, Ont.
Source
CMAJ. 1993 Apr 15;148(8):1331-8
Date
Apr-15-1993
Language
English
Publication Type
Article
Keywords
Adult
Advance Directives - statistics & numerical data
Attitude of Health Personnel
Community Medicine
Family Practice
Female
Geriatrics
Hospitals, Teaching
Humans
Intensive Care
Interviews as Topic
Male
Medical Oncology
Medical Staff, Hospital - psychology
Middle Aged
Nursing Staff, Hospital - psychology
Ontario
Questionnaires
Abstract
This study examined the views and experiences of 20 physicians and 20 nurses at a major Canadian teaching hospital regarding the use of advance directives in clinical care.
The participants were purposively drawn from four clinical specialties: family and community medicine, oncology, intensive care and geriatrics. Detailed interviews were conducted in person. Content analysis was used to code the data, which were further analysed with both quantitative and qualitative techniques.
Thirty-nine of the 40 participants favoured the use of advance directives in clinical care; physicians had somewhat less positive attitudes than nurses toward such directives. Advance directives were thought by participants to be helpful in resolving disagreements between patients and their families about treatment options; in making patients more comfortable, both physically and psychologically, during the process of dying; and in opening up communication and trust among patients, their families and health care professionals. Concerns about the use of advance directives focused on the lack of clarity in some patients' instructions, the absence of legal status for directives, the possible interference with a practitioner's clinical judgement, the adequacy and appropriateness of patients' information about their circumstances, and the type of intervention (passive or active) requested by patients.
New regulations and legislation are making the use of advance directives more widespread. Health care professionals should participate in the development and implementation of these directives. Continuing professional education is essential in this regard.
Notes
Cites: Arch Intern Med. 1989 Aug;149(8):1851-62764656
Cites: JAMA. 1989 Jun 9;261(22):3288-932636851
Cites: JAMA. 1988 Aug 12;260(6):803-73392811
Cites: Arch Intern Med. 1985 Jun;145(6):1115-74004437
Cites: JAMA. 1989 Nov 3;262(17):2411-42795826
Cites: JAMA. 1985 Jan 4;253(1):54-73964898
Cites: Ann Intern Med. 1991 Oct 15;115(8):639-431892335
Cites: CMAJ. 1991 Aug 15;145(4):307-111873764
Cites: CMAJ. 1991 May 1;144(9):1133-82018965
Cites: N Engl J Med. 1991 Mar 28;324(13):889-952000111
Cites: N Engl J Med. 1991 Mar 28;324(13):882-82000110
Cites: N Engl J Med. 1990 Feb 1;322(5):309-152296273
Cites: Gerontologist. 1989 Oct;29(5):615-212599421
Cites: CMAJ. 1990 Jan 1;142(1):23-61688397
Cites: JAMA. 1989 Nov 3;262(17):2415-92795827
PubMed ID
8462055 View in PubMed
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Advanced life support vs basic life support field care: an outcome study.

https://arctichealth.org/en/permalink/ahliterature205160
Source
Acad Emerg Med. 1998 Jun;5(6):592-8
Publication Type
Article
Date
Jun-1998
Author
J S Eisen
I. Dubinsky
Author Affiliation
Queen's University Faculty of Medicine, Kingston, Ontario, Canada.
Source
Acad Emerg Med. 1998 Jun;5(6):592-8
Date
Jun-1998
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cohort Studies
Emergency medical services
Female
Hospital Bed Capacity, 300 to 499
Hospitalization - statistics & numerical data
Hospitals, Teaching
Hospitals, Urban
Humans
Life Support Care - classification
Male
Middle Aged
Ontario
Outcome and Process Assessment (Health Care)
Urban Population
Abstract
To determine whether the provision of advanced life support (ALS) field care has any impact on patient outcome in the urban Canadian environment.
A convenience cohort study was conducted of all emergent ambulance transfers of adults to an urban Canadian hospital from May 22 to July 31, 1996. Data were collected from ambulance call reports regarding presenting complaint and field interventions applied, and from hospital records regarding time in the ED, hospital length of stay (LOS), and discharge disposition. Patient outcomes were compared within 7 presenting complaint groups (chest pain, altered level of consciousness, shortness of breath, abdominal pain, motor vehicle crash, falls, and other) by field care level: level 1--BLS (basic life support) vs levels 2 and 3--ALS.
The study population consisted of 1,397 patients. No significant differences were seen between BLS and ALS patients on baseline demographics. ED triage score did not depend on field care level for any group, implying that those in the ALS group were not inherently sicker. Outcome measures (ED LOS, admission rates, and hospital LOS) showed no significant differences between BLS and ALS for each presenting complaint group. Discharge dispositions were analyzed by chi2 but were not varied enough to allow reliable analysis. Observation of trends suggested no difference between BLS and ALS.
There was no beneficial impact on the measured patient outcomes found in association with the provision of ALS vs BLS field care in Metropolitan Toronto for patients who were brought to a nontrauma center.
PubMed ID
9660286 View in PubMed
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Aetiological diagnosis of infective endocarditis by direct amplification of rRNA genes from surgically removed valve tissue. An 11-year experience in a Finnish teaching hospital.

https://arctichealth.org/en/permalink/ahliterature168994
Source
Ann Med. 2006;38(4):263-73
Publication Type
Article
Date
2006
Author
Pirkko Kotilainen
Maija Heiro
Jari Jalava
Veikko Rantakokko
Jukka Nikoskelainen
Simo Nikkari
Kaisu Rantakokko-Jalava
Author Affiliation
Department of Medicine, Turku University Hospital, Finland. pirkko.kotilainen@utu.fi
Source
Ann Med. 2006;38(4):263-73
Date
2006
Language
English
Publication Type
Article
Keywords
Bacterial Typing Techniques
Bartonella - classification - genetics
DNA, Bacterial - analysis
DNA, Ribosomal - analysis
Endocarditis, Bacterial - diagnosis - microbiology
Female
Finland
Heart Valves - microbiology
Hospitals, Teaching
Humans
Male
Polymerase Chain Reaction
Predictive value of tests
Prospective Studies
Sequence Analysis, DNA
Staphylococcus - classification - genetics
Streptococcus - classification - genetics
Abstract
The aetiology of infective endocarditis (IE) can be determined directly from surgically removed valve tissue using broad-range bacterial rDNA polymerase chain reaction (PCR) followed by sequencing. We sought to assess the value of this methodology in a routine clinical setting.
Broad-range PCR with primers targeting conserved bacterial rDNA sequences was applied to directly analyse valve samples from 56 patients operated on for diagnosed or suspected IE. Identification of the aetiological agent was performed by partial DNA sequencing of the 16S and 23S rDNA genes.
The final diagnosis was definite IE in 36 patients and possible IE in 2 patients, while the diagnosis of IE was rejected in 18 patients. PCR analysis from removed valve tissue was positive in 25 patients with IE. Molecular identification was consistent with the blood culture finding in 20 of these patients. The PCR approach was the only method to yield the aetiological diagnosis in additional 4 patients (2 Staphylococcus species, 1 Streptococcus bovis, 1 Bartonella quintana), all of whom had received antimicrobials before blood cultures were taken. The mean duration of preoperative antimicrobial treatment for the patients with PCR-positive valves was 19.6 (range 1-58) days.
Bacterial DNA may persist during treatment in infected valves for long periods. The PCR method is especially useful when the causative agent of IE is fastidious or when the specimen is taken during antimicrobial treatment.
PubMed ID
16754257 View in PubMed
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Age as a determinant of cardiopulmonary resuscitation outcome in the coronary care unit.

https://arctichealth.org/en/permalink/ahliterature214983
Source
J Am Geriatr Soc. 1995 Jun;43(6):634-7
Publication Type
Article
Date
Jun-1995
Author
C. Brymer
E. Gangbar
K. O'Rourke
G. Naglie
Author Affiliation
Department of Medicine, University of Western Ontario, London, Canada.
Source
J Am Geriatr Soc. 1995 Jun;43(6):634-7
Date
Jun-1995
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Aging
Cardiopulmonary Resuscitation - statistics & numerical data
Coronary Care Units - statistics & numerical data
Coronary Disease - epidemiology
Female
Heart Arrest - therapy
Hospital Mortality
Hospitals, Teaching
Humans
Length of Stay
Male
Middle Aged
Ontario - epidemiology
Patient Discharge
Retrospective Studies
Survival Rate
Tachycardia, Ventricular - epidemiology
Treatment Outcome
Ventricular Fibrillation - epidemiology
Abstract
To determine whether age is associated with the outcome of cardiopulmonary resuscitation (CPR) in the coronary care unit (CCU).
Retrospective chart review.
The coronary care units of two Canadian tertiary care teaching hospitals.
Two hundred sixty-four coronary care unit patients undergoing cardiopulmonary resuscitation between January 1, 1985 and June 30, 1992.
There was no significant difference in survival to discharge after CPR between patients less than 70 years of age (17.0%) and patients 70 years of age and older (17.2%) (odds ratio = 0.99; 95% confidence interval = 0.46, 1.80). Patients 70 years of age and older who survived to discharge after CPR had significantly greater lengths of stay (28.1 vs 19.3 days, P = .008).
Age was not associated with a difference in survival to discharge after CPR in the CCU, although a clinically significant difference could not be excluded because of limited power.
PubMed ID
7775721 View in PubMed
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The ambulatory clinic in a teaching hospital.

https://arctichealth.org/en/permalink/ahliterature110685
Source
Can Med Assoc J. 1968 Apr 27;98(17):812-4
Publication Type
Article
Date
Apr-27-1968

Ambulatory orthopaedic surgery patients' knowledge expectations and perceptions of received knowledge.

https://arctichealth.org/en/permalink/ahliterature161029
Source
J Adv Nurs. 2007 Nov;60(3):270-8
Publication Type
Article
Date
Nov-2007
Author
Katja Heikkinen
Helena Leino-Kilpi
Ari Hiltunen
Kirsi Johansson
Anne Kaljonen
Sirkku Rankinen
Heli Virtanen
Sanna Salanterä
Author Affiliation
Department of Nursing Science, University of Turku, Turku, Finland. katheik@utu.fi
Source
J Adv Nurs. 2007 Nov;60(3):270-8
Date
Nov-2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Ambulatory Surgical Procedures
Female
Finland
Health Knowledge, Attitudes, Practice
Hospitals, Teaching
Humans
Knowledge
Male
Middle Aged
Orthopedic Procedures
Patient Education as Topic
Patient satisfaction
Perception
Questionnaires
Abstract
This paper is a report of a study to compare orthopaedic ambulatory surgery patients' knowledge expectations before admission and their perceptions of received knowledge 2 weeks after discharge.
Advances in technology and population ageing are driving up the number of ambulatory orthopaedic surgical procedures. Shorter hospital stays present a major challenge for patient education.
A descriptive comparative cross-sectional study (pre- and post-test) design was adopted. The data were collected from 120 consecutive patients in 2004, using the Hospital Patient's Knowledge Expectations Scale and Hospital Patient's Received Knowledge Scale. All patients participated in a preoperative education session given by a nurse.
Patients expected more knowledge than they actually perceived that they received on all dimensions except the bio-physiological. They perceived that they received least knowledge about experiential, ethical, social and financial dimensions of knowledge. Knowledge expectations correlated with age and professional education. Perceptions of received knowledge correlated with earlier ambulatory surgery, and both expected knowledge and perceptions of received knowledge were related to the level of basic education.
Patients' knowledge expectations are greater than the knowledge they perceived that they receive, and they cannot become empowered if they lack important knowledge. Further research is needed to learn about meeting patients' knowledge expectations.
PubMed ID
17908124 View in PubMed
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437 records – page 1 of 44.